Search Results (8,184)

Cultivating the best business environment ecosystem is important for advancing market-oriented reforms and achieving sustainable industrial transformation. How to quantify the business environment is also a relatively complex topic. Based on urban ecology theory, this study constructs a comprehensive evaluation framework for assessing urban business environment development. Using the entropy weight method and spatial autocorrelation analysis, we examine the time series and spatial evolution of the business environment in the Guangdong–Hong Kong–Macao Greater Bay Area from 2008 to 2021. Meanwhile, we further explore the main factors that influence the development level of the business environment. Finally, some suggestions are put forward to improve the business environment. The results show that (1) the development level of the business environment has gradually improved during the sample period, with stable growth from 2008 to 2015, followed by rapid development after 2015; (2) from different dimensions, there is an imbalance in the business environment development among cities within the Greater Bay Area, with core cities performing better than others; (3) from a spatial perspective, the business environment presents a “core-periphery” pattern, with higher levels clustered around the Pearl River Estuary, indicating strong spatial agglomeration. This research provides theoretical support and policy recommendations for the Three-Year Action Plan for Creating a World-Class Business Environment in the Greater Bay Area. Full article

Mangroves play a pivotal role in carbon sequestration. To investigate the characteristics and driving factors of carbon sequestration in planted mangrove forests, we focused on planted mangrove forests in Wenzhou City, Zhejiang Province, China. Through a statistical analysis of soil physicochemical properties and plant morphological characteristics, we assessed carbon stock distribution patterns and identified key influencing factors, providing scientific support for the northward expansion of mangroves. The results demonstrated significant differences in soil properties and plant morphological characteristics among different stands (p < 0.05). The mean soil carbon stock of restored planted mangroves was 78.75 Mg C/ha (mature stands: 87.84 Mg C/ha; middle-aged stands: 74.09 Mg C/ha; young stands: 74.31 Mg C/ha), while the average plant carbon stock was 12.28 Mg C/ha, indicating that soil is the primary contributor to carbon sequestration in mangroves. Compared to natural mangroves, the restored planted mangroves still exhibited a lower carbon sequestration capacity. The variations in carbon sequestration levels among the planted mangrove forests were mainly attributed to differences in tree species and age composition, hydrothermal conditions, and biomass carbon quantification methods. Key drivers of soil carbon sequestration included total phosphorus content, bulk density, and clay content. Carbon storage in restored planted mangroves depends on short-term soil carbon accumulation and long-term biomass carbon accumulation. Ultimately, we recommend optimal species selection and planting design, improved soil carbon storage mechanisms, and integrated conservation monitoring systems to enhance carbon sequestration in mangrove plantations. Full article

Facing the global competitive market and ever-changing customer demands, manufacturers must navigate intense competition and uncertain demand while striving to enhance customer satisfaction. As a result, the demand for customized products has become a crucial design consideration. To respond accurately and swiftly in a competitive market, manufacturers must focus on customer needs, analyze market trends and competitor information, and leverage data analysis as a reference for new product development and design. This study presents a new product development model by integrating quality function deployment (QFD), decision-making trial and evaluation laboratory (DEMATEL), analytic network process (ANP), and fuzzy set theory. It first uses a 2-tuple fuzzy DEMATEL to identify significant interrelationships among factors. A revised house of quality (HOQ) is then constructed to map relationships among customer requirements (CRs), engineering requirements (ERs), and the influences of CRs on ERs. To address uncertainty in human judgment, fuzzy set theory is incorporated into the ANP. The integrated model can determine the relative importance of the ERs. The proposed model is applied to touch panel development, and the results are recommended to the R&D team for new product development. Full article

Background: Antimicrobial stewardship programs (ASPs) are essential for promoting the rational use of antibiotics and combating resistance. In South Korea, implementation has recently accelerated, but real-world data on short-term program performance remain limited. This study evaluated the early outcomes of a newly launched ASP at a tertiary hospital. Methods: This retrospective, single-center study analyzed ASP activity from January to April 2025. Interventions included prospective audit and feedback for restricted antibiotics and recommendations for prolonged antibiotic prescriptions (≥14 days). The primary outcome was the monthly rejection rate of restricted antibiotics. Secondary outcomes included days of therapy (DOT) for restricted antibiotics and the acceptance rate of interventions for prolonged prescriptions. Results: The monthly rejection rate of restricted antibiotics remained stable between 3.65% and 4.68%. Although the DOT values did not show statistical significance, they demonstrated a moderate inverse correlation with the rejection rate (Pearson’s r = –0.868, p = 0.132). Among 826 prolonged prescriptions, 513 (62.1%) received ASP intervention. Acceptance of recommendations increased over time, from 67.0% in January to 82.5% in April. Interventions were primarily based on insufficient evidence of infection or inappropriate antibiotic selection. Conclusions: The newly implemented ASP demonstrated feasibility and early impact in improving antibiotic oversight. Despite the short observation period, the findings suggest a positive influence on prescribing practices. Longer-term studies are needed to evaluate sustained clinical outcomes and broader applicability in diverse healthcare settings. Full article

Cisplatin (CIS)-induced peripheral neuropathy and associated comorbidities have a detrimental effect on the lives of cancer patients. Currently, there are no effective therapies to alleviate these symptoms. Duloxetine (DULO) is a recommended treatment, but it is linked with important side effects, thus making it essential to explore novel approaches. We examined the impact of a prophylactic treatment with a low dose of DULO combined with hydrogen-rich water (HRW) on CIS-injected C57BL/6 male and female mice as a possible therapy for allodynia, muscle and body weight deficits, and emotive syndromes accompanying this type of chemotherapy. The prophylactic treatment with DULO and HRW prevented mechanical allodynia caused by CIS in both sexes and had greater effects than either treatment given individually. The combined treatment also prevented cold allodynia in male mice but only reduced it in females. Moreover, the coadministration of DULO with HRW avoided muscular deficits in both sexes. Furthermore, the body weight reduction induced by CIS in both sexes was not entirely mitigated by the combined therapy. However, all treatments avoided the anxiety- and depressive-like behaviors elicited by CIS. The antiallodynic actions and prevention of muscular deficits produced by the combined treatment might be explained by the inhibition of oxidative stress, inflammatory responses, and plasticity alterations provoked by CIS in the dorsal root ganglia of these subjects. This study proposes, for the first time, the cotreatment of DULO with HRW as an effective therapy for CIS-induced peripheral neuropathy and reveals the influence of sex on these actions. Full article

The upper reaches of the Yangtze River face the challenge of balancing livestock development and ecological protection. As a significant livestock production region in China, optimizing the livestock ecological efficiency (LEE) of Sichuan Province (SP) is of strategic importance for regional sustainable development. Livestock carbon emissions and related pollution indices were utilized as undesirable output indicators within the super-efficiency SBM model to measure SP’s LEE over the 2010–2022 period. Kernel density estimation was combined with the Theil index to analyze spatiotemporal variation characteristics. A STIRPAT model was constructed to explore the influencing factors of SP’s LEE, and a grey forecasting GM (1,1) model was employed for prediction. Key findings reveal the following: (1) LEE increased by 25.9%, with high-efficiency regions expanding from 19.0% to 57.1%; (2) regional disparities persist, driven by labor redundancy and environmental governance gaps; (3) per capita GDP, industrial agglomeration, and technology advancement significantly promoted efficiency, while government subsidies and carbon intensity suppressed it. Projections show LEE reaching 0.923 by 2035. Key recommendations include the following: (1) implementing region-specific strategies for resource optimization, (2) restructuring agricultural subsidies to incentivize emission reduction, and (3) promoting cross-regional technology diffusion. These provide actionable pathways for sustainable livestock management in ecologically fragile zones. Full article

Urban tree planting on single-family-home lots represents a critical yet underexplored component of municipal greening strategies. This study examines residents’ perceptions of tree planting in Westpointe, a diverse neighborhood in Salt Lake City, Utah, as part of the city’s Reimagine Nature Public Lands Master Plan development effort. Through a mixed-methods approach combining qualitative interviews (n = 24) and a tree signup initiative extended to 86 residents, with 51 participating, this research explores the complex interplay of demographic, economic, social, and infrastructure factors influencing residents’ willingness to plant trees on single-family-home lots. The findings reveal significant variations based on gender, with women expressing more positive environmental and aesthetic motivations, while men focused on practical concerns including maintenance and property damage. Age emerged as another critical factor, with older adults (65+) expressing concerns about long-term maintenance capabilities, while younger families (25–44) demonstrated future-oriented thinking about shade and property values. Property characteristics, particularly yard size, significantly influenced receptiveness, with owners of larger yards (>5000 sq ft) showing greater willingness compared to those with smaller properties, who cited space constraints. Additional barriers, i.e., maintenance, financial, and knowledge barriers, included irrigation costs, lack of horticultural knowledge, pest concerns, and proximity to underground utilities. Geographic analysis revealed that Spanish-speaking social networks were particularly effective in promoting tree planting. The study contributes to urban forestry literature by providing nuanced insights into single-family homeowners’ tree-planting decisions and offers targeted recommendations for municipal programs. These include gender-specific outreach strategies, age-appropriate support services, sliding-scale subsidy programs based on property size, and comprehensive education initiatives. The findings inform evidence-based approaches to increase urban canopy coverage through private property plantings, ultimately supporting climate resilience and environmental justice goals in diverse urban neighborhoods. Full article

Background/Objectives: Chemotherapy is an aggressive form of oncological treatment often accompanied by numerous adverse effects. A patient’s baseline status significantly influences the course of therapy, its efficacy, quality of life, and overall survival. This review aims to analyze the published peer-reviewed studies in this area and to assess whether they permit the formulation of preliminary recommendations for future prehabilitation protocols. Methods: An integrative review was conducted due to the limited number of relevant studies. Four databases—MEDLINE/PubMed (Medical Literature Analysis and Retrieval System Online/National Library of Medicine), Scopus, Cochrane, and Web of Science—were systematically searched for English-language articles published between 2010 and 13 January 2025, using the terms “prehabilitation,” “chemotherapy,” “drug therapy,” and “neoadjuvant.” A total of 162 records were retrieved. After duplicate removal, titles and abstracts were screened. The remaining papers were subjected to detailed analysis, resulting in ten studies with diverse methodologies being included. Results: We reviewed ten (n = 10) studies, most of which were reviews focused on breast cancer, indicating variation in the state of knowledge across different cancer types. A protein intake of 1.4 g/kg body mass helps preserve fat-free mass, with whey being more effective than casein. Omega-3 fatty acid supplementation at a dose of 2.2 g/kg may prevent chemotherapy-related neurotoxicity and support appetite and weight maintenance. Physical activity, especially when it includes strength training, improves VO₂max, preserves fat-free mass, and may reduce stress and anxiety. We identified one randomized controlled trial in which a single exercise session before the first dose of doxorubicin resulted in a smaller reduction in cardiac function. Continuous psychological support should be available. A combined behavioural and pharmacological approach appears to be the most effective strategy for smoking cessation. Conclusions: No official guidelines exist for prehabilitation before chemotherapy, and the availability of studies on this topic is very limited. The pre-treatment period represents a critical window for interventions. Further research is needed to evaluate the effectiveness and applicability of particularly single-component interventions. Full article

Background/Objectives: Physical training and Pulmonary Rehabilitation in Patients with Cystic Fibrosis: A Systematic Review and Meta-Analysis of Clinical Trials. Pulmonary rehabilitation and physical training are essential components of the comprehensive management of patients with cystic fibrosis. Despite documented benefits for some clinical outcomes, uncertainty exists regarding their overall effects. Therefore, the objective of the present meta-analysis is to determine the effectiveness of physical training and pulmonary rehabilitation in patients with CF. Methods: This systematic review and meta-analysis of randomized controlled trials published between 1990 and 2025 was conducted using the PubMed, Cochrane Clinical Trial, SCOPUS, Science Direct, Web of Science, Scielo, and LILAC databases. The risk of bias was evaluated using the RoB 2 tool, the quality of the evidence with the Jadad scale, and the certainty of the evidence for each outcome was assessed according to GRADE guidelines. This meta-analysis was developed using the statistical packages RevMan 5.4^® and Jamovi 2.3.28^®. Results: Twenty-three studies with a total of 800 patients with CF were included. This meta-analysis showed that pulmonary rehabilitation and physical training did not affect pulmonary function, as observed in FEV1 (SMD: 0.05; 95% CI: −0.09 to 0.20; p = 0.46) and FVC (SMD: 0.11; 95% CI: −0.04 to 0.27; p = 0.14). However, it has a discrete impact on exercise capacity, producing an increase in VO₂ max (MD: 2.74; 95% CI: 0.43 to 5.04; p = 0.02). Subgroup analyses did not yield relevant findings, and sensitivity analyses did not produce modifications in the direction or magnitude of the effect. Conclusions: The intervention evaluated in this meta-analysis does not have effects on pulmonary function but may influence exercise capacity, particularly VO₂ max. It is recommended to interpret the findings with caution due to the limited certainty of the available evidence. Full article

Small and Medium Enterprises (SMEs) are vital to economic growth, innovation, and job creation across Sub-Saharan Africa (SSA). Women entrepreneurs are key contributors to this sector, yet they face persistent barriers to accessing finance, which constrain their business growth and broader economic participation. This study investigates the role of financial institutions in closing the financing gap for women-owned SMEs and assesses the effectiveness of various financing mechanisms, including traditional banking, micro-finance, fintech innovations, and government-backed credit schemes. Adopting a quantitative approach, this study utilises structured surveys with women SME owners across multiple SSA countries. Supplementary secondary data from sources such as the World Bank and national financial statistics provide additional context. Econometric modelling and Structural Equation Modelling (SEM) are employed to identify key factors influencing loan accessibility, such as collateral requirements, interest rates, financial literacy, and the regulatory environment. Findings reveal that high collateral demands and interest rates remain major obstacles, particularly for smaller or informal women-led enterprises. Financial literacy emerges as a critical enabler of access to credit. While fintech solutions and digital lending platforms show promise in improving access, issues around infrastructure, regulation, and trust persist. Government-backed schemes also contribute positively but are hindered by implementation inefficiencies. This study offers practical recommendations, including the need for harmonised regional credit reporting systems, gender-responsive policy frameworks, and targeted financial education. Strengthening digital infrastructure and regulatory support across SSA is essential to build inclusive, sustainable financial ecosystems that empower women entrepreneurs and drive regional development. Full article

Supporting dementia carers is a global priority. As a Randomised Controlled Trial (RCT) (n = 352) of the Word Health Organization recommended, an internationally disseminated ‘iSupport’ e-health intervention was conducted, revealing no measurable benefits to the wellbeing of adult dementia carers. This process evaluation contributes original insights of the trial outcomes. Its aims were to ascertain the usability and acceptability of iSupport, participant engagement and adherence to iSupport, and contextual factors influencing its implementation and potential impact. The process evaluation followed a mixed-method design. The following data were collected from all participants randomised to iSupport (n = 175): (1) post-intervention evaluation questionnaire (n = 93) containing the 10-item System Usability Scale and bespoke items exploring acceptability, engagement, and perceived impact; (2) qualitative interviews (n = 52) with a sub-sample of participants who were purposively sampled according to age, scores on the outcome measures, and gender, as these interviews aimed to generate contextual detail and explanatory accounts; and (3) ‘Access’ data from the iSupport platform (n = 175). Descriptive statistics was used to report on the frequency of survey responses whilst a thematic analysis approach was followed to identify themes from the qualitative interview data. Data sets were analysed independently and then used with respect to one another in order to generate explanatory pathways related to the usability, acceptability, and the impact of iSupport. Despite good trial retention, 8.3% of participants (n = 32) did not spend any time on iSupport, and 54% (n = 94) spent between 30 min and 1.5 h. Factors driving this were the following: time constrains, method of delivery, and content characteristics. Positive impacts of iSupport were also described. Participants, including those with extensive caring experience, reported how iSupport had made them feel reassured, valued, and more able to ask for help. They also reported having an improved outlook on their caring role and on the needs and feelings of the person living with dementia. Research and practice should focus on exploring blended delivery, including self-directed and interactive components, such as regular contact with a health professional. These insights are critical for supporting the global implementation and adaptation of iSupport and offer valuable directions for future research. Full article

A total of 162 groundwater samples were collected during November and December 2022 in the Xin’an River Basin during the dry season. In this research, the concentrations of various indicators in most samples did not exceed the prescribed standards. The indicators with the largest number of exceedances were iodine and manganese, with 22 and 23 samples, respectively. Overall, the groundwater quality in the Xin’an River Basin was generally good, with only 7 samples with the EWQI values greater than 150, which exhibited poor groundwater quality. The primary factors influencing groundwater quality were the concentrations of I, Mn, and Al, which were predominantly affected by water–rock interactions. Groundwater quality in the Xin’an River Basin was mainly influenced by natural factors rather than anthropogenic activities. Both the carcinogenic and non-carcinogenic health risks posed by groundwater in the Xin’an River Basin were higher for children than for adults. The long-term chronic cumulative effect was the most important factor contributing to both carcinogenic and non-carcinogenic health risks. Iodine presented the highest non-carcinogenic health risks for both adults and children. In regions where high-iodine groundwater was distributed, it is recommended to enhance the monitoring of iodine concentrations in the groundwater. Full article

Background/Objective: To assess vulnerable Romanian children’s knowledge, attitudes, and beliefs regarding the HPV vaccination. Methods: Vulnerable children (ethnic minorities, high social vulnerability index, or low socioeconomic status) from three schools in Cluj County, Romania, were enrolled in a short educational presentation regarding HPV and were delivered a physical questionnaire consisting of 26 items. Results: 199 vulnerable school students concluded the questionnaire with a mean age of 14.62. Most participants were unaware of the HPV infection or the HPV vaccine. Following the educational program, most participants exhibited a reasonably elevated level of knowledge, which positively correlated with the intention to vaccinate. Fifty-three per cent of respondents would vaccinate in school if the vaccine were available, fifty-four per cent would vaccinate if the product were free of charge or at minimal cost, and over sixty-four per cent would vaccinate at their doctor’s recommendation. Several knowledge items, beliefs, and attitudes towards vaccination were disclosed to influence children’s preference to participate in vaccination campaigns. Conclusions: This analysis unveiled the pivotal role of knowledge about HPV in the immunization uptake within underserved, vulnerable populations of Romanian children. An intricate interplay between vulnerability, knowledge, accessibility, and the willingness to vaccinate was impacted by several beliefs and attitudes towards HPV vaccination. Most children were willing to participate in HPV immunization campaigns, whether school-based, reimbursed, or at the doctor’s recommendation. These findings act as pillars for assembling future educational campaigns in vulnerable Romanian communities of children, aiming to enhance awareness and coverage of HPV vaccination and ensure inclusive health policies. Full article

To explore the influence of waste plastics on the self-healing ability of bitumen, the healing effect of multiple damages, and enlarge the utility of waste plastic in pavement through dynamic shear rheology (DSR) tests, multiple repeated loading tests with fatigue–healing–fatigue as the basic cycle were conducted on modified bitumen samples containing five types of waste plastics (PET, HDPE, PP, PS, and PVC) with different dosages. The damage healing ability of bitumen of the same waste plastic with different dosage ratios and the same dosage of different waste plastics under the same healing time, loading strain, and damage degree through single and multiple loading were explored and analyzed. The results show that based on the three sets of data of the complex shear modulus, phase angle, and fatigue factor, the PS and PVC-modified bitumen have a better recovery performance than that of the other three types of modified bitumen, and the latter also has the best fatigue resistance property. To maximize the improvement effect on the healing index of bitumen, the recommended optimal dosages of PET, HDPE, PP, PS, and PVC are 2%, 2%, 2%, 6%, and 4%, respectively. PS has the best promoting effect on the damage healing ability of bitumen after undergoing multiple damages, while PET has the worst improvement effect. The findings can provide theoretical support and guidance for the wide application of waste plastic-modified bitumen pavement. Full article

Climate change poses unprecedented challenges to forest ecosystems. Betula alnoides, a tree species with significant ecological and economic value in southern China, has been the subject of studies on its distribution pattern and response to climate change. However, research on the distribution pattern of B. alnoides and its response to climate change remains relatively limited. In this study, we developed a MaxEnt model incorporating multiple environmental variables, including climate, topography, soil, vegetation, and human activities, to evaluate model performance, identify key factors influencing the distribution of B. alnoides, and project its potential distribution under various future climate scenarios. Species occurrence data and environmental layers were compiled for China, and model parameters were optimized using the ENMeval package. The results showed that the optimized model achieved an AUC value of 0.956, indicating extremely high predictive accuracy. The four key factors affecting the distribution of B. alnoides were standard deviation of temperature seasonality (Bio4), normalized difference vegetation index (NDVI), mean temperature of driest quarter (Bio9), and annual precipitation (Bio12). Among them, the cumulative contribution rate of climatic factors reached 68.9%, but the influence of NDVI was significantly higher than that of precipitation factors. The current suitable habitat of B. alnoides is mainly concentrated in the southwestern region, covering an area of 179.32 × 10⁴ km², which accounts for 18.68% of China’s land area. Under the SSP126 scenario, the suitable habitat area first decreases and then increases in the future, while under the SSP370 and SSP585 scenarios, the suitable habitat area continues to shrink, with significant losses in high-suitability areas. In addition, the centroid of the suitable habitat of B. alnoides shows an overall trend of shifting northwestward. This indicates that B. alnoides is highly sensitive to climate change and its distribution pattern will undergo significant changes in the future. In conclusion, the distribution pattern of B. alnoides shows a significant response to climate change, with particularly prominent losses in high-suitability areas in the future. Therefore, it is recommended to strengthen the protection of high-suitability areas in the southwestern region and consider B. alnoides as an alternative tree species for regions facing warming and drying trends to enhance its climate adaptability. Full article